<html>

<head>
{% include "googleAnalictsHead.html" %}

<script src="/static/js/jquery.js" type="text/javascript"></script>
<script src="/static/js/jquery.validate.min.js" type="text/javascript"></script>

<script id="formValidation" type="text/javascript">
$(document).ready(function() {
	// validate signup form on keyup and submit
	var validator = $("#signupform").validate({
		rules: {
			FirstName: "required",
			LastName: "required",			
			Email: {
				required: true,
				email: true,
			},
			EmailReEnter: {
				equalTo: '#Email',
			},
			Gender: {
				required: true,
			},
			BirthDate : {
				required: true,
				date: true,
			},
			PostalAddress: {
				required: true,
			},
			PrimaryPhone: {
				required: true,
			},
			SecondaryPhone: {
				required: false,
			},
			AllowUserToSeePhone: {
				required: true,
			},
			Nationality: {
				required: true,
			},
			HaveChildren: {
				required: true,
			},
			ChildrenAccompaignAges : {
				required: false,
			},
		},
		
		// set this class to error-labels to indicate valid fields
		success: function(label) {
			// set &nbsp; as text for IE
			label.html("&nbsp;").addClass("checked");
		}
	});
});
</script>
</head>


<body topmargin="0" background="static/images/bg.gif">

<div style="text-align: center; ">
{% include "header.html" %}
        
<p>
We are looking for nannies, fill up this form it's free. Nannies pay nothing, when service starts we send you an email.
<p>Give you more business opportunities, fillup this form!

<p> Subscribed nannies {{ count }}


<form action="/sign" method="post" id="signupform" name="signupform"  >
<div  >
	<table style="margin-left:auto; margin-right:auto; background-color: #efefef;">
		<tr>
			<td>First name:</td>
			<td><input type="text" name="FirstName" id="FirstName"></input></td>
		</tr>
		<tr>
			<td>Last name:</td>
			<td><input type="text" name="LastName" id="lastName"></input></td>
		</tr>
		<tr>
			<td>Email:</td>
			<td><input type="text" name="Email" id="Email"></input></td>
		</tr>
		<tr>	
			<td>Email (re-enter):</td>
			<td><input type="text" name="EmailReEnter" id="EmailReEnter"></input></td>
		</tr>
		<tr>	
			<td>Gender:</td>
			<td>
			<input type="radio" name="Gender" id="Gender" value="Female" checked="checked">Female
			<input type="radio" name="Gender" id="Gender" value="Male">Male
		</tr>
		<tr>	
			<td>Birth Date:</td>
			<td><input type="text" name="BirthDate" id="BirthDate"></input></td>
		</tr>
		<tr>	
			<td>Postal Address:</td>
			<td><input type="text" name="PostalAddress" id="PostalAddress"></input></td>
		</tr>
		<tr>	
			<td>Primary Phone:</td>
			<td><input type="text" name="PrimaryPhone" id="PrimaryPhone"></input></td>
		</tr>
		<tr>	
			<td>Secondary Phone:</td>
			<td><input type="text" name="SecondaryPhone" id="SecondaryPhone"></input></td>
		</tr>
		<tr>	
			<td>Allow users (parent) to see your phone:</td>
			<td>
			<input type="radio" name="AllowUserToSeePhone" id="AllowUserToSeePhone" value="Yes"  checked="checked">Yes
			<input type="radio" name="AllowUserToSeePhone" id="AllowUserToSeePhone" value="No">No
			</td>
		</tr>
		<tr>	
			<td>Nationality:</td>
			<td><input type="text" name="Nationality" id="Nationality"></input></td>
		</tr>
		<tr>	
			<td>Do you have children:</td>
			<td>
			<input type="radio" name="HaveChildren" id="HaveChildren" value="Yes" checked="checked">Yes
			<input type="radio" name="HaveChildren" id="HaveChildren" value="No">No
			<td>
		</tr>
		<tr>	
			<td>If your children will accompaign you, enter their ages:</td>
			<td><input type="text" name="ChildrenAccompaignAges" id="ChildrenAccompaignAges"></input></td>
		</tr>
		<tr><td colspan="2">	
		    <input type="submit" value="Sign !">
		    </td>
		</tr>
	</table>
	</div>
</form>


</div>

<p align="center"><img src="http://code.google.com/appengine/images/appengine-silver-120x30.gif" 
alt="Powered by Google App Engine" /></p>


</div>
</body>
</html>
